The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Fun in the Sun, While Avoiding the Risks

Written by
Erica Howard, MS
Posted in
Move more

Thursday, Jul 12, 2012

It’s that time of year again—foodies are eating on restaurant balconies, fitness buffs have moved their workouts outside, and outdoorsmen embark upon their seasonal hobbies. However, one of the most common trends is participating in water-related activities (1), hoping for relief from high temperatures and summer humidity.  Swimming is fun. According to the Centers for Disease Control (CDC), it is the second most popular sport activity among males and females in the United States (1). Swimming is social, refreshing AND at the same time, a great form of physical activity!

Although swimming makes for a great pastime during the warmer months, we need to practice healthy and safe swimming behaviors in order to increase health benefits and limit risks.

There are many health benefits to swimming.  This low-weight bearing exercise has been linked to increased function in people with arthritis, including osteoarthritis and rheumatoid arthritis (2). Submersion in waist to neck deep water decreases weight load by up to 90% on the body (3), which allows individuals with hip and ankle joint pain to partake in exercise that would be painful on land.  The unloaded feeling of being in the water often allows individuals to increase their exercise intensity as well. As a matter of fact, for those whose interest is in weight loss, leisurely swimming has been measured at a metabolic intensity of 6.0, according to the Compendium of Physical Activity (4). Basically, metabolic intensity is a measure of how hard the activity is or how much work you are doing. Here is how it compares to other fun summer activities:

  • Sitting still and quiet on a lawn chair in the shade reading a book--1 MET
  • Canoeing on the lake--4 METs
  • Normal-paced walking--4.5 METs
  • Leisure swimming--6 METs
  • Swimming laps, vigorous, fast--9.8 METs
Click here for a more detailed explanation of METs.

So, swimming ranks high in terms of energy, or calorie, use.  Thus, it’s great for losing weight and avoiding those extra pounds. And for those who are carrying extra weight, it is a great choice for making exercise more comfortable, feasible, and enjoyable. But before grabbing your bathing suit, let’s first recognize a few risks.

The Dallas Morning News reported an increase in sunburns from 2005 to 2010, stating, “The warnings about skin cancer from too much sun don’t seem to be getting through (9).”  33.7% of the U.S. population reported at least 1 sunburn in 2003 (6) and it looks as if those numbers are only increasing (9). Sun burns are a risk factor for both basal cell carcinoma and melanoma (6). A person’s risk for melanoma doubles with 5 or more sunburns throughout a lifetime (Skin Cancer Foundation). So, heed the warning and wear hats, sunglasses, protective clothing and apply sunscreen liberally (7). This is particularly important for children.  Sunscreen specifics from American Academy of Dermatology are listed below (ADA):

  • Use broad spectrum, water resistant sunscreen (SPF30).
  • Use  EVERY day, year around
  •  Sunscreen should be used by EVERYONE.
  • 1 ounce (a shot glass) is the average recommended  amount  used to protect uncovered skin.
  • Reapply every 2 hours when swimming
There are several risks associated with being in the water as well. Some Recreational Water Illnesses (RWI) are not always prevented by chlorine and wreak havoc on persons who have swallowed, breathed, or had contact with contaminated water.  Several well known examples include:  1)  Cryptosporidiosis,  Giarda, or E. coli which present with diarrhea,  2)  Hot tub rash which looks bumpy and red  with blisters and itchiness, and 3) swimmers ear with swelling and redness around the ear (10). Here are a few suggestions from the CDC in order to keep RWI at bay (5):
  • Do not swim or allow your child to swim with diarrhea.
  • Avoid swallowing water.
  • Shower with soap before getting into the pool.
  • Always wash hands after using the restroom.
  • Kids should have regular bathroom breaks.
After properly protecting yourself from RWI, we must practice safe procedures to avoid water related injuries. Perhaps the most tragic injury, drowning, affected nearly 4,000 individuals in 2007. As the sixth leading cause of unintentional injuries among all ages, it is imperative to increase safe swimming behaviors to reduce drowning risk. CDC recommends several strategies to decrease water related injuries. Here are a few (8):
  • Children should have “touch supervision” when in or around the water.  The child should never be out of reaching distance from the designated supervisor.
  • Use the buddy system. Two people are always more fun and “safer” than one.
  • Learn to swim.
  • Wear life jackets. I hear they are the new fashion trend.
  • To learn more, click here.
Summer 2012 only comes around once; so get out and enjoy the water but remember to do so in a safe and responsible manner.
  1. U.S. Census Bureau. 2011 Statistical Abstract of the United States. Recreation and leisure activities: participation in selected sports activities 2006. Retrieved May 22, 2012 from  [PDF - 454 kb]
  2. Verhagen AP, de Vet HCW, de Bie RA, Kessels AGH, Boers M, Knipschild PG. Balneotherapy for rheumatoid arthritis and osteoarthritis. Cochrane Database Syst. Rev, 2001;(1)
  3. Kravitz, L., & Mayo, J.J. (1997). The physiological effects of aquatic exercise: A brief review. Nokomis, Fl. Aquatic Exercise Association. Aqua Exercise Review. Retrieved May 23, 2012 from %20folder/aqua.html
  4. Water Activities. Compendium of Physical Activities 2011. Retrieved May 21, 2012 from
  5. Centers for Disease Control and Prevention. Surveillance for Waterborne Disease Outbreaks – United States, 1993-1994. MMWR 1996:45(No. SS-1). Available at
  6. Centers for Disease Control and Prevention. Sunburn Prevalence Among Adults---United States, 1999, 2003, and 2004. MMWR 2007: 56 (21); 524-528
  7. Prevention. CDC. Retrieved may 21, 2012 from
  8. Injury Prevention & Control: Home and Recreational Safety. CDC. Retrieved May 22, 2012, from
  9. Stobbe, M. (May 11, 2012). Skin cancer warnings go unheeded. Dallas Morning News, pg 2.
  10. Centers for Disease Control and Prevention. Healthy Swimming/Recreational Water. Available at Retrieved June 5, 2012